浙江省义乌市2016年新报告HIV/AIDS的HIV-1亚型和传播簇分析

张佳峰; 姚佳明; 范钦; 陈婉君; 潘晓红; 丁晓贝; 杨介者; 傅涛

Abstract

张佳峰,姚佳明,范钦,陈婉君,潘晓红,丁晓贝,杨介者,傅涛.浙江省义乌市2016年新报告HIV/AIDS的HIV-1亚型和传播簇分析[J].Chinese journal of Epidemiology,2017,38(12):1688-1693

浙江省义乌市2016年新报告HIV/AIDS的HIV-1亚型和传播簇分析

Analysis on HIV-1 subtypes and transmission clusters in newly reported HIV/AIDS cases in Yiwu, Zhejiang Province, 2016

Received:June 18, 2017

DOI：10.3760/cma.j.issn.0254-6450.2017.12.021

KeyWord: 艾滋病病毒和艾滋病亚型传播簇耐药

English Key Word: HIV/AIDS Subtype Transmission cluster Drug resistance

FundProject:浙江省医药卫生科技计划（2016RCB004）

Author Name	Affiliation	E-mail
Zhang Jiafeng	Department of HIV/AIDS and STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Yao Jiaming	School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou 325035, China
Fan Qin	Department of HIV/AIDS and STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Chen Wanjun	Department of HIV/AIDS and STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Pan Xiaohong	Department of HIV/AIDS and STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China	xhpan@cdc.zj.cn
Ding Xiaobei	Department of HIV/AIDS and STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Yang Jiezhe	Department of HIV/AIDS and STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Fu Tao	Yiwu Municipal Center for Disease Control and Prevention, Yiwu 322000, China

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Abstract:

目的了解浙江省义乌市HIV亚型分布和传播簇特征，为HIV流行趋势分析和疫情防治提供依据。方法对该地区2016年新报告HIV/AIDS开展分子流行病学横断面研究，从168例血浆中提取RNA，通过RT-PCR和巢式PCR扩增pol基因并测序。构建系统进化树分析亚型和传播簇，通过CPR 6.0在线软件工具分析耐药突变位点。结果研究对象年龄（39.1±13.4）岁，男性为主（86.3%，145/168），外省户籍居多（66.7%，112/168），感染途径为同性传播（51.2%，86/168）和异性传播（48.8%，82/168）。HIV序列成功获得率为89.9%（151/168），优势亚型为CRF01_AE 74例（49.0%）和CRF07_BC 64例（42.4%），其他亚型包括CRF08_BC 5例（3.3%），CRF55_01B 3例（2.0%），B、CRF45_cpx、CRF59_01B、CRF85_BC和URF （B/C）各1例。CRF45_cpx和CRF85_BC在浙江省首次发现。共发现26个传播簇（含65个病例），总成簇比例43.0%（65/151），CRF01_AE成簇比例54.1%（40/74），高于CRF07_BC的32.8%（21/64）；各传播簇平均大小为2.5例/簇，CRF01_AE中异性传播的传播簇最大（3.5例/簇）。传播性耐药率为4.6%（7/151），7例检出监测性耐药突变，包括M46L 5例，F77L和Y181C各1例。结论义乌市HIV亚型复杂多样，多种传播簇并存且特征多样，应继续加强亚型监测，重点对传播簇病例开展专题调查，实施针对性有效干预。

English Abstract:

Objective To understand the characteristics of distribution on HIV-1 subtypes and the transmission clusters in Yiwu in Zhejiang province.Methods A cross-sectional study of molecular epidemiology was carried out on newly reported HIV/AIDS cases in Yiwu. RNA was extracted from 168 plasma samples, followed by RT-PCR and nest-PCR for pol gene amplification, sequencing, phylogenetic tree construction used for analyzing the subtypes and transmission clusters. Mutations on drug resistance was analyzed by CPR 6.0 online tool.Results Subjects were mainly males (86.3%, 145/168), with average age as (39.1±13.4) years old and most of them were migrants (66.7%, 112/168). The major routes of transmission included homosexual (51.2%, 86/168) and heterosexual (48.8%, 82/168) contacts. The rate of success for sequence acquisition was 89.9% (151/168). The dominant subtypes showed as CRF01_AE (74, 49.0%) and CRF07_BC (64, 42.4%), followed by CRF08_BC (5, 3.3%), CRF55_01B (3, 2.0%), each case of subtype B, CRF45_cpx, CRF59_01B, CRF85_BC and URF (B/C). CRF45_cpx and CRF85_BC were discovered the first time in Zhejiang province. Twenty-six transmission clusters involving 65 cases were found, with the total clustered rate as 43.0% (65/151), in which the CRF01_AE clustered rate appeared as 54.1% (40/74), higher than that of CRF07_BC (21/64, 32.8%). The average size of cluster was 2.5 cases/cluster, with average size of cluster in CRF01_AE patients infected through heterosexual transmission as the largest (3.5 cases/cluster). The prevalence of transmitted drug resistance was 4.6% (7/151). Seven cases with surveillance drug resistant mutations (SDRM) were found, including 5 cases of M46L (3.3%), and one case of F77L or Y181C.Conclusion HIV genetic diversity and a variety of transmission clusters had been noticed in this study area (Yiwu). Programs on monitoring the subtypes and transmission clusters should be continued and strengthened.

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